The experience of having a preterm baby admitted to NICU is enormously challenging for families. The birth often rapidly descends into a frightening, emergency situation followed by separation from their critically unwell infant. They then learn that the infant may face serious, long term health complications and they must wait to find out if their baby has a brain injury, lung disease or a myriad of other possible health issues. The life of the baby or the mother may be at risk, or both. Parents are then catapulted into the complex new world of the neonatal ward.
Depression, Anxiety and Post-traumatic Stress Symptoms
It is hardly surprising that parents with very preterm infants (born <32 weeks) report higher rates of mental health distress, than parents of healthy infants born at term. In a recent study, around 35% of mothers and fathers reported clinically elevated levels of depression, anxiety and posttraumatic stress symptoms following the birth of their child at <32 weeks gestation. Further to this, is the concerning finding that these mental health symptoms remained elevated for approximately one fifth of mothers and approximately one fifth of fathers two years after the birth of their child (Pace, Anderson, Lee, Spittle & Treyvaud, 2020).
What is Good for Parents is Good for Infants, Including Preterm Infants
There is an extensive body of research in infant and child mental health, showing that interventions to support parents with mental health difficulties is good for everyone – parents and infants. The same is also true for families with preterm infants.
Recommendations for Supporting Parents following Preterm Birth
How should this support be structured?
Treyvaud, Spittle, Anderson and O’Brien (2019) developed a series of recommendations which were based upon a review of clinical guidelines, intervention studies and parent outcomes research.
They recommended that support for parents in the NICU after preterm birth ought to be multilayered, with consideration of the mental health needs of the parent, the emotional and physical health of the infant, as well as support for the parent-infant relationship.
They make the following suggestions regarding interventions for families following preterm birth:
- Screening Programs – to screen for mental health symptoms and psychosocial risk amongst all parents of infants born preterm in the NICU, however there must also be a capacity for intervention and response when required.
- Individualised and/or Group Psychological Support for all parents within the NICU.
- Processes for referral to access specialised assessment, intervention or ongoing psychological support following discharge which is linked to internal and external services.
- Peer-to-peer support that is overseen by and integrated into the NICU.
- Family Centred Care approaches within the hospital which promote the provision of individualised psycho-social support to parents. This approach also encourages parents to be involved in the direct delivery of care to their baby.
- Support for NICU staff (including psychoeducation) who have high levels of contact with parents.
- Psychological support for the parent-infant relationship is integral and may also be effective when integrated with early intervention programs that focus on enhancing infant development.
After Discharge from Hospital:
Families also often require ongoing support following discharge from NICU. This should include screening, follow-up assessment, intervention, and/or referral to specialist ongoing psychological support. A multidisciplinary approach is often warranted and of great benefit.
Summary:
Given the emphasis upon optimising development in preterm infants, where there is already a heightened risk of developmental and emotional difficulties, a focus upon strengthening parent-infant relationships presents a window for enhancing outcomes in early intervention programs.
At the Centre for Clinical Psychology, we have a dedicated team of perinatal psychologists who are trained in perinatal and infant mental health, as well as having additional training in trauma treatments.
The Centre for Clinical Psychology has trained over 750 mental health professionals from around Australia in Cognitive Processing Therapy for PTSD. We know trauma therapy.
Call to book an appointment 03 9077 0122 or email admin@ccp.net.au.
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